OP30.12: The diagnostic value of transvaginal sonography compared to hysteroscopy in endometrial polyp and submucous fibroid detection

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.

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To compare the diagnostic accuracy of hysteroscopy with transvaginal sonography in detection of endometrial polyp and endometrial hyperplasia in peri and postmenopausal women with abnormal uterine bleeding

Indian Journal of Obstetrics and Gynecology Research ◽

10.18231/j.ijogr.2020.107 ◽

2020 ◽

Vol 7 (4) ◽

pp. 498-503

Author(s):

Surbhi Sharma ◽

◽

Anoop Sharma ◽

Keyword(s):

Diagnostic Accuracy ◽

Postmenopausal Women ◽

Endometrial Hyperplasia ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Endometrial Polyp ◽

Transvaginal Sonography

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OP07.03: 3D-transvaginal sonography by VCI analysis to differentiate endometrial polyp and hyperplasia in pre-menopausal women

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.7985 ◽

2010 ◽

Vol 36 (S1) ◽

pp. 71-71

Author(s):

F. Leone ◽

C. Marciante ◽

A. Crepaldi ◽

G. Tosi ◽

E. Ferrazzi

Keyword(s):

Endometrial Polyp ◽

Transvaginal Sonography ◽

Menopausal Women

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OP16.01: Reproducibility of 3D-transvaginal sonography by VCI analysis to differentiate endometrial polyp and hyperplasia in pre-menopausal women

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.13787 ◽

2014 ◽

Vol 44 (S1) ◽

pp. 111-111 ◽

Cited By ~ 1

Author(s):

F. Leone ◽

F. Parisi ◽

C. Marciante ◽

A. Crepaldi ◽

C. Lanzani ◽

...

Keyword(s):

Endometrial Polyp ◽

Transvaginal Sonography ◽

Menopausal Women

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Mathematical Models to Discriminate Between Benign and Malignant Adnexal Masses: Potential Diagnostic Improvement Using Ovarian HistoScanning

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e3182000528 ◽

2011 ◽

Vol 21 (1) ◽

pp. 35-43 ◽

Cited By ~ 3

Author(s):

Evelien Vaes ◽

Ranjit Manchanda ◽

Rina Nir ◽

Dror Nir ◽

Harry Bleiberg ◽

...

Keyword(s):

Mathematical Models ◽

New Technology ◽

Characteristic Curve ◽

Model Performance ◽

Diagnostic Value ◽

Ca 125 ◽

Transvaginal Sonography ◽

Future Research ◽

Initial Report ◽

Adnexal Masses

Purpose:Accurate preoperative clinical assessment of adnexal masses can optimize outcomes by ensuring appropriate and timely surgery. This article addresses whether a new technology, ovarian HistoScanning, has an additional diagnostic value in mathematical models developed for the differential diagnosis of adnexal masses.Patients and Methods:Transvaginal sonography-based morphological variables were obtained through blinded analysis of archived images in 199 women enrolled in a prospective study to assess the performance of ovarian HistoScanning. Logistic regression (LR) and neural network (NN) models including these variables and clinical and patient data along with the HistoScanning score (HSS) (range, 0-125; based on mathematical algorithms) were developed in a learning set (60% patients). The remaining 40% patients (evaluation set) were used to assess model performance.Results:Of all morphological and clinical variables tested, serum CA-125, presence of a solid component, and HSS were most significant and used to develop the LR model. The NN model included all variables. The novel variable, HSS, offered significant improvement in the LR and NN models' performance. The LR and NN models in an independent evaluation set were found to have area under the receiver operating characteristic curve = 0.97 (95% confidence interval [CI], 94-99) and 0.93 (95% CI, 88-98), sensitivities = 83% (95% CI, 71%-91%) and 80% (95% CI, 67%-89%), and specificities = 98% (95% CI, 89%-99%) and 86% (95% CI, 72%-95%), respectively. In addition, these models showed an improved performance when compared with 3 other existing models (allP< 0.05).Conclusions:This initial report shows a clear benefit of including ovarian HistoScanning into mathematical models used for discriminating benign from malignant ovarian masses. These models may be specifically helpful to the less experienced examiner. Future research should assess performance of these models in prospective clinical trials in different populations.

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Diagnostic Value of Outpatient Endometrial Aspiration and Transvaginal Sonography vs Inpatient Hysteroscopy in Evaluation of Abnormal Uterine Bleeding

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1335 ◽

2019 ◽

Vol 53 (4) ◽

pp. 143-146

Author(s):

Vinita Sarbhai ◽

Tanvisha Singla

Keyword(s):

Abnormal Uterine Bleeding ◽

Diagnostic Value ◽

Uterine Bleeding ◽

Transvaginal Sonography

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Accuracy of transvaginal sonography in evaluation of abnormal uterine bleeding in perimenopausal women

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20196018 ◽

2019 ◽

Vol 9 (1) ◽

pp. 187

Author(s):

Nicole Sequeira ◽

Shannon Fernandes

Keyword(s):

Sensitivity And Specificity ◽

Endometrial Thickness ◽

Abnormal Uterine Bleeding ◽

Diagnostic Value ◽

Transvaginal Sonography ◽

College Hospital ◽

Endometrial Polyps ◽

Medical College ◽

Perimenopausal Women ◽

A Prospective Study

Background: AUB is a commonly encountered complaint in peri- and postmenopausal women visiting OBG OPDs and accounts for about 70% of all gynaecological complaints. Key to management depends on the cause of AUB. Protocol has changed over the years from performing investigations randomly to a condition specific approach. This study aims to evaluate and compare the efficacy of transvaginal sonography and hysteroscopy in perimenopausal women with AUB and note its relation with histopathology.Methods: A prospective study was conducted on 103 women of 40-55 years presenting to the OBG OPD of Father Muller Medical College Hospital, Mangalore. All patients underwent a transvaginal scan to note the endometrial thickness followed by a hysteroscopy and biopsy. Endometrium was sent for histopathology. Findings of these modalities were correlated.Results: The diagnostic value of transvaginal sonography in relation to histopathology had a sensitivity and specificity of 33.33% and 95.95% for atrophic endometrium, 52.5% and 62.9% for proliferative, 29.41% and 79.41% for secretory, and 55.55% and 74.19% for hyperplastic. When compared to histopathology, hysteroscopy had a sensitivity and specificity of 100% and 92.3% for atrophic, 26.19% and 96.96% for proliferative, 27.07% and 98.59% for secretory, and 100% and 64.94% for hyperplastic endometrium. It had a sensitivity of 77.77% and a specificity of 92.92% for endometrial polyps. Agreement between TVS and histopathology based on kappa co-efficient was fair for atrophic endometrium but poor for proliferative, secretory and hyperplastic endometrium. Agreement between hysteroscopy and histopathology was moderate for atrophic endometrium and for endometrial polyps. It was fair for proliferative, secretory and hyperplastic endometrium.Conclusions: TVS seems to be a good initial method for evaluation of AUB. However, a subsequent hysteroscopy with biopsy is advisable to evaluate the cause of AUB.

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